  <fieldset data-role="controlgroup">
	
           <p>
          1.
             <input name="input" type="text" value="" size="" placeholder=" option1" class="ui-input-text ui-body-c ui-corner-all ui-shadow-inset">
           </p>
            <p>
         2.
             <input name="input" type="text" value="" size="" placeholder=" option1" class="ui-input-text ui-body-c ui-corner-all ui-shadow-inset">
           </p>
            <p>
        3.             <input name="input" type="text" value="" size="" placeholder=" option1" class="ui-input-text ui-body-c ui-corner-all ui-shadow-inset">
           </p>
   	   
      
      </fieldset>
      
             <input name="Ajouter2" type="submit" class="ui-btn-up-b" value="ajouter une option" data-inline="true"  data-icon="plus" data-iconpos="right">